How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Facility | None | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier None Typical Low $2.45 Median $4.90 Typical High $5.01 | Professional | None | $2.45 | $4.90 | $5.01 |
Cigna Setting Facility Modifier None Typical Low $3.02 Median $5.62 Typical High $5.62 | Facility | None | $3.02 | $5.62 | $5.62 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.62 Typical High $7.08 | Professional | None | $5.13 | $5.62 | $7.08 |
Hally Health Setting Professional Modifier None Typical Low $5.01 Median $6.31 Typical High $11.22 | Professional | None | $5.01 | $6.31 | $11.22 |
Medica Setting Facility Modifier None Typical Low $3.39 Median $5.50 Typical High $79.43 | Facility | None | $3.39 | $5.50 | $79.43 |
Medica Setting Professional Modifier None Typical Low $2.45 Median $4.27 Typical High $10.96 | Professional | None | $2.45 | $4.27 | $10.96 |
Midlands Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.89 | Professional | None | $5.62 | $5.62 | $5.89 |
Midlands Setting Professional Modifier None Typical Low $4.27 Median $8.32 Typical High $8.32 | Professional | None | $4.27 | $8.32 | $8.32 |
United Setting Professional Modifier None Typical Low $2.14 Median $2.51 Typical High $4.37 | Professional | None | $2.14 | $2.51 | $4.37 |
Wellmark Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
2 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $0.74 Typical High $0.76 | Professional | 55 · Aftercare only | $0.42 | $0.74 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.49 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.28 | $0.49 | $0.50 |
Where Iowa sits
The same service costs 2.2 times more in Kansas than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Iowa· 6th of 51
$4.90
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.